Silent danger

Women on alert as doctors call for greater vigilance in fight to curb potential hidden killer

Leading specialists are raising the alarm amid growing concerns over the diagnosis of ovarian cancer, with only a quarter of cases caught early. This poses the question of why are so many cases going unnoticed? Ovarian cancer is most common in women who have been through the menopause, but it can affect any woman at any time in her life. Spotting the signs and an early diagnosis can mean the difference between life and death. As the fifth most common cancer, more than 7,100 women are diagnosed with ovarian cancer every year in the UK, and devastatingly, the majority – around three-quarters – are only noticed once the cancer has spread. Dr Indragit Fernando, consultant clinical oncologist at Birmingham’s BMI The Priory Hospital, believes more needs to be done to encourage early diagnosis, and urges younger women to take the time to find out the symptoms of the cancer – 20 percent of cancers affect those under the age of 50. “Early diagnosis is crucial,” said Dr Fernando. “Ovarian cancer is often called the ‘silent cancer’ as patients do not develop symptoms until after it has spread, causing a more advanced tumour that is more difficult to locate and treat. The symptoms are similar to those of irritable bowel syndrome, but a patient who develops new symptoms of bloating, swelling, change in bowel habit or abdominal pains needs to be investigated.”

KEY RISKS

While the exact causes of ovarian cancer have yet to be discovered, Dr Fernando highlighted key factors that are known to increase a woman’s risk of getting the disease:

1. Age: The risk of ovarian cancer goes up as you grow older. “Most cases of ovarian cancer happen after the menopause, which is why around eight in 10 cases of the disease are in women over 50,” said Dr Fernando.

2. Height and weight: The risk of ovarian cancer is higher in women who have a Body Mass Index (BMI) above 30, but haven’t been through the menopause yet. Research has also found taller women are more at risk of ovarian cancer than shorter women. “Although a woman cannot reduce her height, she can reduce her weight and avoid obesity to reduce her risk factors,” said Dr Fernando.

3. Smoking: Increases the risk of mucinous ovarian tumours. If you stop smoking, your risk will eventually go back down to normal.

4. Family history: If you have at least two close relatives – your mother, sister or daughter – who have had ovarian or breast cancer, you have a higher risk of developing the condition.

5. Hormone Replacement Therapy: “HRT has been shown to be linked to a rise in the risk of ovarian cancer, especially when using oestrogen only preparations,” said Dr Fernando. “There is no increased risk in past users, which suggests that women who need HRT for menopausal symptoms should take them for as short a time as possible.”

6. Breast cancer: If you have had breast cancer, you could have twice the risk of ovarian cancer compared to women who haven’t. This is because sometimes breast cancer and ovarian cancer are linked to the same faulty genes.

7. Fertility: Dr Fernando explained: “When your ovaries release an egg each month, the surface bursts to let it out. Every time this happens your ovary has to repair itself which means cells need to divide. The more times your ovary produces an egg, the more times it needs to repair itself and the greater the chance of abnormal cell growth. This could be why your risk of ovarian cancer falls if you take the pill, have multiple pregnancies or breastfeed. During these times, your ovaries do not release eggs.”